In Virginia, a solid waste is considered a RMW if
it is capable of producing an infectious disease in humans or if it
is not excluded under the regulations. RMW includes:

Cultures and stock of microorganisms and biologicals;

Human blood and human body fluids;

Tissues and other anatomical wastes;

Sharps. (needles, syringes, etc.);

Animal carcasses, body parts, bedding and related
wastes that are known to be infected with human pathogens;

Any residue or contaminated soil, water, or other
debris resulting from the cleanup of a spill of any RMW; and

Any solid waste contaminated by or mixed with RMW.

Managing Regulated Medical
Waste (RMW)

Permit Requirements

If you treat, store, or dispose of RMW, you
are required to have a permit for the management of RMW, unless exempt
under the regulations.

Permit-by-Rule

Facilities that meet the following conditions
may be qualified to operate under a permit for RMW management activities
and their owners or operators are not required to comply with permit
issuance procedures:

The facility and all RMW
activities are in compliance with all state and local requirements;

More than 75% (by weight,
in a calendar year) of all RMW that is stored, treated or disposed
of by the facility is generated on-site;

No RMW is transported from
or received by the facility without being properly packaged and
labeled. Facilities storing RMW will indicate the first date that
the waste was placed in storage date on the outer packaging of
the RMW;

The activities at the facility
do not involve the placing of RMW directly into or on the land;

The owner or operator of
the facility has notified the director in writing that the facility
is operating under an on-site permit by rule;

The owner or operator of
the facility has submitted to the director a certification from
the local governing body, without qualifications, conditions, or
reservations, that the location and operation of the facility are
consistent with all applicable ordinances;

The owner or operator of
the facility has submitted to the director appropriate Key Personnel
Disclosure Statements; and

A person certified by the
Board of Waste Management Facility Operators will operate the facility.

Packaging and Labeling

Generators of RMW are responsible for the packaging
and labeling of the wastes. Once a bag or container becomes full,
it must be sealed, labeled and managed in accordance with the regulations.
Contractors or other agents may provide services to the generator,
including packaging and labeling of RMW, if the packaging or repackaging
is performed on-site where the RMW was generated and no transportation,
storage, treatment or disposal occurs prior to the packaging or repackaging.

All RMW shall be packaged as follows:

When RMWs are discarded,
they shall be placed in containers that meet the requirements of
the standards for occupational exposure to bloodborne pathogens.
The general industry standard requires the packaging to be closable,
constructed to prevent leakage, labeled with the biohazard symbol,
and closed to prevent spillage during handling. Upon being placed
in storage, red bags shall be used for the packaging of all RMW.
Packaging shall be labeled as required;

Contaminated sharps shall
be placed directly in containers as required by the general industry
standards. The containers shall be labeled as required;

As bags and containers become
full, they shall be sealed such that no waste materials can leak;

Prior to transporting RMW,
waste will be packaged for transportation in accordance with the
standards of 49 CFR Part 173 or packaged in accordance with an
exemption approved by the United States Department of Transportation;

Waste shall be labeled.
The label shall be securely attached to or printed on packaging.
The label may be a tag securely affixed to the package. Indelible
ink shall be used to complete the information on the label. The
label and the information provided on the label must be clearly
legible. The following information shall be included:

The name, address and
business telephone number of the generator;

"RMW" in large print; and

The Biological Hazard Symbol.

All etiological agents that are transported
must be packaged and labeled in accordance with federal and other
applicable regulations;

Sharps must be placed directly into puncture
resistant containers as required by the general industry standards
in 16VAC25-90-1910.1030(d)(4)(iii)(A); and

RMW may be conveyed in reusable carts or containers
under the following conditions:

The waste in the cart or container is packaged
and labeled fully in accordance with state regulations;

Immediately following each time a reusable cart
or container is emptied and prior to being reused it is thoroughly
cleaned with detergent or general purpose disinfectant; and

When reusable carts or containers containing RMW
are used for off-site transport, all aspects of the cart or container
management shall comply with all applicable federal Department of
Transportation Hazardous Material Regulations.

Spill Containment and Cleanup Kit

All RMW management facilities are required to keep a spill containment
and cleanup kit within the vicinity of any area where RMW is managed.
The kit location shall provide for rapid and efficient cleanup of spills
anywhere within the area. All vehicles transporting RMWs are required
to carry a spill containment and clean up kit whenever RMWs are conveyed.

Containment and Cleanup Procedures

If there is a RMW spill, the following procedures shall be implemented:

Take appropriate precautions to ensure personnel
do not come into contact with any contaminants by wearing appropriate
personal protective equipment;

Materials used to decontaminate the area will be
disinfectants effective against mycobacteria; and

Take necessary steps to replenish containment and
cleanup kit.

Treatment and Disposal

All regulated medical
waste must be incinerated, sterilized by steam, or treated by a
method as described in the RMW regulations.

No RMW shall be disposed
of in a solid waste landfill or other solid waste management facility.
Upon authorized treatment and management, the solid waste or its
ash is not RMW and may be disposed of at any permitted landfill
or other permitted solid waste management facility.

Regulated medical waste in closed bags or containers
shall not be compacted or subjected to violent mechanical stress;
however, after it is fully treated and it is no longer regulated
medical waste, it may be compacted in a closed container.

Closure Requirements

When a facility that has been used for RMW management is to cease
operations involving regulated medical wastes, it shall be thoroughly
cleaned and disinfected. All RMW shall be disposed of, and all equipment
decontaminated.

Recordkeeping Requirements

Unless a generator is exempt from recordkeeping requirements, generators
and RMW management facilities shall maintain the following accurate
records for three years:

A list of the members of any committee for the
management of infection control for the facility, their address,
their phone numbers and the period of their membership;

The date, persons involved and short description
of events in each spill of more than 32 gallons of regulated medical
waste or one quart of regulated medical waste consisting of free
liquid;

A notebook or file containing the adopted policies
and procedures of the facility for dealing with regulated medical
wastes;

A log of all special training received by persons
involved in regulated medical waste management; and

A log of regulated medical waste received from
off-site, the generator, the amount and its storage and receipt dates.
Records shall be maintained for a period of three years and be available
for review.

All RMW management facilities shall maintain the following accurate
records:

A signed certificate for each load received in
which the generator affirms that the load does not contain hazardous
waste or radioactive materials; and

signed and effective contract, inclusive of all
loads received from a generator, in which the generator affirms that
all loads will not contain hazardous waste radioactive materials,
except as provided under the regulations.

Transporting Regulated Medical
Waste

All transporters must be
registered with the DEQ prior to transporting any RMW and been
issued a registration number.

RMW stored for more than
seven days must be refrigerated and kept at an ambient temperature
between 35 and 45 degrees Fahrenheit. A vehicle that is parked
for more than 24 hours during transport will be considered a storage
facility.

A covered loading area is
not required if RMW are in a container that is resistant to the
elements

In addition to the state medical waste environmental
regulations there are some Occupational Safety and Health Administration
(OSHA) rules that apply to medical/infectious waste. Virginia
is one of 21 states operating an approved occupational safety and health
program. This program is operated by the Virginia Department of Labor
and Industry. OSHA rules (Occupational Exposure to Bloodborne Pathogens
Standards) impact various aspects of medical/infectious waste, including
management of sharps, requirements for containers that hold or store
medical/infectious waste, labeling of medical/infectious waste bags/containers,
and employee training. These requirements can be found in the
VetCA section entitled OSHA Standards for Regulated Waste